Lacrimal drainage anomalies in Tessier cleft 3 with unilateral anophthalmos

2019 ◽  
pp. 112067211989147
Author(s):  
Swati Singh ◽  
Abhimanyu Sharma ◽  
Vikas Mittal ◽  
Mohammad Javed Ali
Keyword(s):  
Drainage System ◽  
Nasolacrimal Duct ◽  
Anatomical Location ◽  
Lacrimal Sac ◽  
Duct Obstruction ◽  
Lacrimal Drainage System ◽  
Computed Tomographic ◽  
The Right ◽  
Current Report ◽  
Lacrimal Drainage

Bilateral Tessier cleft types 3 and 4 are rare and commonly involve the lacrimal drainage system owing to their anatomical location. Such clefts commonly present with associated ocular anomalies and include colobomatous eyelids, hypertelorism, microphthalmia, punctal or canalicular agenesis, and nasolacrimal duct obstruction or exstrophy. The current report presents an 18-month-old baby with bilateral Tessier cleft 3 with a unilateral anophthalmos, symmetrical eyelid colobomas, and lacrimal drainage anomalies. The lacrimal anomalies noted include small lacrimal sac with inferior canaliculus on the right side and upper and lower punctal and canalicular agenesis on the left side. Computed tomographic dacryocystography demonstrated unilateral lacrimal sac and bilateral maldevelopment of the bony nasolacrimal duct.

Usefulness of high definition sialoendoscope for evaluation of lacrimal drainage system in congenital nasolacrimal duct obstruction

2021 ◽  
pp. 112067212110080
Author(s):  
Nishi Gupta ◽  
Poonam Singla ◽  
Suma Ganesh
Keyword(s):  
Light Transmission ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
High Definition ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Lacrimal Drainage System ◽  
Membranous Obstruction ◽  
Lacrimal Drainage

Purpose: Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported. Methods: Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). This was followed by Dacryoendoscopy (DEN) of the lacrimal drainage system from puncta till the valve of Hasner. DEN was performed under general anaesthesia in 26 children (including 17 primary and 9 failed probing cases). All cases were examined using 0.8 mm sialoendoscope (Karl Storz, Tuttlingen, Germany) with fibreoptic light transmission with a side port for irrigation. Results: We were able to obtain high-definition images of canaliculi, lacrimal sac, sac duct junction, proximal, mid and distal segments of nasolacrimal duct in all the children with CNLDO. In 17 primary cases 16 had distal membranous obstruction and I case had proximal canalicular obstruction. In nine children with history of failed probing, five had membranous obstruction, two had dacryoliths, two had NLD malformation at different levels. An overall success rate of 88.4% was achieved. Conclusion: Sialoendoscope can be used as high-definition dacryoendoscope for diagnostic and therapeutic use in CNLDO. Useful information can be obtained on dacryoendoscopy in complex CNLDO cases.

scholarly journals Incidence of acquired lacrimal drainage system obstruction in epiphoric patients in Thailand

2010 ◽  
Vol 4 (1) ◽  
pp. 159-162
Author(s):  
Suppapong Tirakunwichcha ◽  
Ehwika Rengwanidchakul ◽  
Somkiat Asawaphureekorn ◽  
Supaporn Tengtrisorn ◽  
Khanchai Juangphanich ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Dry Eye ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Common Cause ◽  
Duct Obstruction ◽  
Lacrimal Drainage System ◽  
Medical Centers ◽  
Outpatient Departments ◽  
Lacrimal Drainage

Abstract Background: There were few reports regarding the incidence of the acquired nasolacrimal duct obstruction, and the incidence in different geography or countries might be alike. Since the nasolacrimal drainage system obstruction is a common problem in Thailand, knowledge of the incidence may disclose the burden of the disease that has never been reported. Objectives: Evaluate the incidence of acquired lacrimal drainage system obstruction (ALDO) in Thailand. Methods: This study was conducted in multi-centers. It was based on prospective and descriptive design. All patients with epiphoric symptoms visiting the outpatient departments of five tertiary eyecare centers were recruited between 2004 and 2007. Features of epiphoric symptoms and medical history were recorded, and complete ophthalmic examinations were performed. Results: Epiphoric patients were enrolled from all medical centers with 245 eligible patients, female:male ratio was 4.2:1. Ninety-nine patients (40%) had duration of epiphoric symptoms between one-five years. ALDO was found in 111 patients (45%) with female preponderance (6.9:1). Seventy-one patients (64%) had pre-sac obstruction and 40 patients (36%) had post-sac obstruction. Among other causes of epiphora, dry eye was the most common. Conclusion: The most common cause of epiphora was ALDO. The four-year incidence rate of ALDO among epiphoric patients was 45%.

scholarly journals Congenital Lacrimal Fistula in a Seven-Year-Old Female: A Rare Cause of Epiphora

2020 ◽  
Author(s):  
Praveena Kher ◽  
Jigna Motwani
Keyword(s):  
Surgical Management ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Medial Canthus ◽  
Direct Communication ◽  
Developmental Abnormalities ◽  
Duct Obstruction ◽  
Lacrimal Fistula ◽  
Rare Diagnosis ◽  
Lacrimal Drainage

Congenital lacrimal fistulas are rare epithelium-lined tracts that tend to have a direct communication between skin and the lacrimal drainage system. These are benign developmental abnormalities, that may require no treatment. This is a rare diagnosis since patients are usually asymptomatic and presents only when epiphora is associated. When symptomatic, congenital lacrimal fistula presents as epiphora, or mucoid discharge, rarely patients could develop nasolacrimal duct obstruction, which may present as recurrent dacryocystitis. Thorough clinical examination is the best way to diagnose the condition, where a fistula ostium may be found inferonasal to medial canthus of the eye. Further, lacrimal probing and irrigation is helpful. Surgical management of the fistula is advised only if the disease is symptomatic which ranges from simple excision to dacryocystorhinostomy. This is a report of one such patient with congenital lacrimal fistula which was treated surgically by fistulectomy.

Evaluation of the Lacrimal System

2011 ◽  
Author(s):  
John V. Linberg
Keyword(s):  
Drainage System ◽  
Nasolacrimal Duct ◽  
Careful Examination ◽  
History Taking ◽  
Lacrimal Drainage System ◽  
Anatomy And Physiology ◽  
Tear Production ◽  
System P ◽  
Concomitant Reduction ◽  
Lacrimal Drainage

The common complaint of a watering eye may be caused by a variety of problems, including lacrimal hyposecretion, lacrimal hypersecretion, or blockage of the lacrimal drainage system. This system is a complex membranous channel whose function depends on the interaction of anatomy and physiology. Effective tear drainage depends on a variety of factors, including the volume of tear secretion, eyelid position, and anatomy of the lacrimal drainage passages. Epiphora is defined as an abnormal overflow of tears down the cheek. The patient with symptomatic tearing may have a normal lacrimal drainage system overwhelmed by primary or secondary (reflex) hypersecretion or a drainage system that is anatomically compromised and unable to handle normal tear production. On the other hand, a patient with partial drainage obstruction may have a concomitant reduction in tear production and therefore be completely asymptomatic or may even suffer from symptomatic dry eye syndrome. Epiphora is determined by the balance between tear production and tear drainage, not by the absolute function or dysfunction of either one. The causes of lacrimal drainage problems can be divided into two categories: anatomic and functional. Anatomic obstruction refers to a mechanical or structural abnormality of the drainage system. The obstruction may be complete, such as punctal occlusion, canalicular blockage, or nasolacrimal duct fibrosis, or partial, caused by punctal stenosis, canalicular stenosis, or mechanical obstruction within the lacrimal sac (i.e., dacryolith or tumor). In patients with functional obstruction, epiphora results not from anatomic blockage but from a failure of lacrimal drainage physiology. This failure may be caused by anatomic deformity such as punctal eversion or other eyelid malpositions, but can also result from lacrimal pump inadequacy caused by weak orbicularis muscle action. It is helpful to determine whether the patient’s complaint is true epiphora or a “watery eye.” Detailed history-taking and careful examination will help direct the evaluation of a tearing eye. A host of clinical tests have been described, and the selection of appropriate tests will depend on the initial history and ophthalmic examination. 13-1-1 History-Taking. Any clinical evaluation should begin with a thorough history. A complaint of watery eye does not necessarily imply a lacrimal drainage problem.

scholarly journals Nasolacrimal Duct Obstruction Caused by Lymphoproliferative Infiltration in the Course of Chronic Lymphocytic Leukemia

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0130 ◽  
Author(s):  
Ralph Litschel ◽  
Marco Siano ◽  
Abel-Jan Tasman ◽  
Sergio Cogliatti
Keyword(s):  
Standard Treatment ◽  
Malignant Tumors ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Lymphocytic Leukemia ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Proactive Approach ◽  
Lymphatic Leukemia ◽  
Lacrimal Drainage

Background Endoscopic dacryocystorhinostomy (DCR) is the standard treatment of nasolacrimal duct obstruction. Only in rare cases, blockage may be caused by malignant tumors and even more exceptionally by lymphatic neoplasms so that biopsies are not routinely taken for diagnostic purposes. Methods A computerized retrieval system was used for this retrospective study to identify all patients with histologically documented lymphoproliferative infiltration in the lacrimal drainage system from 2001 to 2009. Results In four of 191 patients (2.1%), infiltration of the nasolacrimal sac mucosa with a small lymphocytic lymphoma (SLL)/chronic lymphatic leukemia (CLL) was found. Patients who develop symptoms like epiphora within the course of known CLL are highly suspicious for lymphoproliferative infiltration of the lacrimal drainage associated lymphoid tissue. Conclusion A proactive approach with ophthalmologic consultation and DCR should be followed in these patients to avoid dacryocystitis.

The Relationship of Lateral Osteotomies in Rhinoplasty to the Lacrimal Drainage System

1986 ◽  
Vol 94 (3) ◽  
pp. 362-367 ◽  
Author(s):  
J. Regan Thomas ◽  
Nancy Griner
Keyword(s):  
Drainage System ◽  
Osteotomy Site ◽  
Lacrimal Sac ◽  
Lacrimal Duct ◽  
Lacrimal Drainage System ◽  
Lacrimal System ◽  
Resident Surgeon ◽  
Relationship Of ◽  
The Relationship ◽  
Lacrimal Drainage

Damage to the lacrimal drainage system is a potentially complicating factor in rhinoplasty utilizing lateral osteotomies. The authors present data from osteotomies performed on a series of fresh cadavers. Following completion of the osteotomies, the lacrimal sac and nasal lacrimal ducts were Identified and cannulated. Soft tissue was dissected to demonstrate the osteotomy site. The specimen was inspected to delineate involvement (if any) of the lacrimal duct or sac. The proximity of the osteotomy site to the lacrimal drainage apparatus components was measured in each specimen. Various parameters were observed, including the effect of curved vs. straight osteotomes, guarded vs. unguarded osteotomes, and the effect of various widths of osteotomes. Likewise, the degree of risk to the lacrimal system was evaluated, and the technique of the novice and resident surgeon was compared to that of the experienced rhinoplastic surgeon. A low, curved osteotomy, performed with a sharp osteotome without subperiosteal tunnels, provides the safest maneuver. Lateral osteotomies, properly performed, prove to be an unusual cause of lacrimal drainage dysfunction.

scholarly journals Small Cell Neuroendocrine Carcinoma of the Lacrimal Sac Presenting with Lacrimal Duct Obstruction

2021 ◽  
Vol 62 (9) ◽  
pp. 1282-1286
Author(s):  
Yeong A Choi ◽  
Junhyuk Son
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Nasolacrimal Duct ◽  
Small Cell ◽  
Lacrimal Sac ◽  
Lacrimal Duct ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Duct Obstruction ◽  
First Case ◽  
Bony Destruction ◽  
The Right

Purpose: We report a case of primary small cell neuroendocrine carcinoma arising from the lacrimal sac. Case summary: A 54-year-old man presented with epiphora that had been present for 1 month. He underwent lacrimal syringe analysis of the lower punctum in the right eye, which demonstrated fluid regurgitation from the upper punctum. Computed tomography revealed a 3.0 × 3.4 × 3.0 cm mass with an ill-defined margin in the right lacrimal sac, which demonstrated invasion of the lacrimal duct and bony destruction of the inferior and medial orbital walls. Incisional biopsy and histologic examination showed that the tumor was composed of small round tumor cells. On the basis of histopathological and immunohistochemical evaluations, a diagnosis of small cell neuroendocrine carcinoma was made. The patient received chemotherapy.Conclusions: To the best of our knowledge, this is the first case of primary small cell neuroendocrine carcinoma arising from the lacrimal sac in Korea. Small cell neuroendocrine carcinoma in the lacrimal sac should be regarded as a differential diagnosis for patients with a nasolacrimal duct obstruction.

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